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On the Importance of Expectation in Hypnosis and Psychotherapy

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On the Importance of Expectation in Hypnosis and Psychotherapy Wright State University CORE Scholar Human Services Faculty Publications Human Services 10-20-2013 On the Importance of Expectation in Hypnosis and Psychotherapy Rubin Battino Wright State University - Main Campus, [email protected] Follow this and additional works at: https://corescholar.libraries.wright.edu/human_services Part of the Psychology Commons Repository Citation Battino, R. (2013). On the Importance of Expectation in Hypnosis and Psychotherapy. https://corescholar.libraries.wright.edu/human_services/7 This Article is brought to you for free and open access by the Human Services at CORE Scholar. It has been accepted for inclusion in Human Services Faculty Publications by an authorized administrator of CORE Scholar. For more information, please contact [email protected]. Rob McNeilly creating solutions together On The Importance of Expectation in Hypnosis and Psychotherapy Rubin Battino, M.S., Mental Health Counseling Expectation is considered to be the basis of the placebo effect in both medicine and psychotherapy. Expectation involves hope and anticipation and wishing. In the beginning psychoanalysis and psychodynamic approaches were structured for long-term involvement with a client, frequently going on for many years. As psychotherapy developed the expectation was for fewer and fewer sessions. We now have brief therapy and very brief therapy and single-session therapy. Hoyt (2009) gives an excellent history of brief therapy, along with a scholarly based introduction to the subject. In my practice I function as a very brief therapist, rarely seeing clients more than one or two times (more if they request). Let me relate how I arrived at this way of working. I heard the late Steve de Shazer describe a research project carried out at the Brief Therapy Center of Milwaukee. Clients were told randomly at intake that their particular presenting problem usually took five or ten sessions with a therapist. The therapists did not know about this. At follow-up at a sufficient later time it was found that the clients who were told ten sessions began to do “serious” work in their 8th or 9th session, and that the clients told five sessions did this generally in the 4th session. Having spent most of my life as an academic scientist I did a simple extrapolation and wondered what would happen if a client were told that his/her concerns could be resolved to their satisfaction in one session (two if really needed). So, I began telling clients that I worked as a very brief therapist who rarely saw clients more than one or two times. My expectation was one or two sessions, and this turned out to be the case with most of my clients. The late Kay Thompson was fond of saying something like, “If you do not believe in what you are doing, then why should the client?” I believe. It also undoubtedly helps that my sessions are always open-ended with respect to time. (I believe that the record for this is Milton H. Erickson’s 17 hour session—mine is about three hours.) Since I have written a book about how I work in this mode (2006), I will just mention a few of the things that I do here. Solution Focused Brief Therapy (SFBT) – A session frequently involves some use of the SFBT Miracle Question with its expectation that the client will create in their post-miracle thinking such realistic and appealing life changes that they cannot but help incorporate them into their lives. The trick, if you will, is to get the client to provide as much detail as you can elicit for their post-miracle life. Connected with this is suggesting a number of ways they can act AS-IF their life has changed in a particularly desirable way. Narrative Therapy – When a client is stuck (why they come to see you) they feel as if they cannot act differently, i.e., they are being controlled in some way by internal forces. Externalization is then used to suggest to the client that the controlling power/entity can be resisted and overcome and even “exorcized.” My clients generally like the exorcize image and we work out ways for this to happen. When and how have they successfully resisted or overcome this internal demon? Usually, this work is done in the hypnosis segment of the session, but it can be done directly. Gestalt Therapy Two-Chair – With a surprising number of clients the Gestalt Therapy two-chair procedure is just the correct thing to do. This is the case with polarities within the client, and with conflicts with parents or other relatives or people. When a client really gets into switching roles he/she is usually in some level of trance. O’Hanlon’s Inclusivity – People frequently get stuck in their lives as being either this or that. They are either okay or sad, depressed, anxious, overeating, or what -have-you. It is a mind-shocking experience to think that they might be happily depressed, calmly anxious, desperately at ease, sadly joyful, or overeating fewer calories. These oxymoronic statements can be quite life-changing (they are also a form of reframing). Reframing – Suggesting a different meaning to an event or feeling or experience can be revolutionary. Being stuck means interpreting what is happening in one’s life in only one way. Reframing provides alternate meanings, and allows the client to view his/her life from a changed perspective. Thinking of behaviors in different contexts is also a reframing. To perceive one’s self differently is change that is lasting. Stories – Telling stories and building metaphors that contain within them alternative ways of being and thinking allow the client to discover new ways of living and acting. I tell lots of stories, many of them personal. Hypnosis for Consolidation – It is generally accepted that people are more receptive to suggestions while they are in a trance state. The hypnosis segment of a session usually occurs at the end and is used to consolidate and repeat the various themes that have emerged during the session. New suggestions are introduced and woven into the tapestry of the session. The client’s inner mind can then pick and choose what makes most sense for them. Many relevant possibilities are introduced here. Milton H. Erickson was an artist in structuring a session with a client so that various expectations were “seeded” at the beginning of the session and then utilized at later appropriate times. People anticipate change in various ways. Anticipating going to a hospital for surgery can be scary in terms of the procedure or it can be hopeful in terms of the expected outcome. When I got a full knee replacement I did not look forward to the surgery or the long rehab period, but I certainly looked forward to being able to walk and hike comfortably. Which aspect do you focus on? When you focus on the hopeful and positive aspects of change the negative aspects dim and blur and can be quickly forgotten or overlooked. When hoped-for change is seeded, then it is more likely to occur. The placebo effect is about anticipating positive change and healing and health. The literature shows it to be remarkably effective. That is why my expectation is that therapy will proceed rapidly and effectively. Expect happiness and health and joy and the probability of rapid change. Battino, R. (2006). Expectation. The very brief therapy book. Carmarthen, UK: Crown House Publishing Ltd. Hoyt, M.F. (2009). Brief psychotherapies. Principles & practices. Phoenix, AZ: Zeig, Tucker & Theisen Inc. .
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